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www.intrainingsurgery.com
VOL. 2, ISSUE 1 • 2011
IN PRACTICE
ABSITE
NL1121 DSL#11-0651 / ENDO1134-VOL3
continued from page 7
The role of intensive review courses is less clear. Residents have a wide range of choices for ABSITE preparation. Online courses, such as www.absite.org, cost around $75; live 2-day seminars offered throughout the winter can cost up to $475, not including accommodations at the review site. One recent survey of program directors found 60% agreed that review courses help the performance of their residents on the ABSITE, but 80% had no institutional or regional review curriculum. Similarly, 90% allowed their residents to attend commercial review courses, but 60% did not reimburse them.2 Ultimately, Dr. Harthun advised that it is important to understand just how competitive the test is and to avoid overreacting about a bad score. “Twenty questions one way or the other can put you at the far ends of the curve,” she said. However, a poor result isn’t the end of a young surgeon’s career. “No one has ever proven a correlation between ABSITE scores and clinical performance, and that has been researched a few times,” Dr. Harthun said. When residents in his department do poorly, Dr. Matthews sees it as a wake-up call to balance their natural judgment and instincts with an increased knowledge base. “I tell them, quite frankly, some of the most gifted surgeons that I have known have initially performed poorly on standardized tests,” he said. Although the test often is seen as a yardstick for a resident’s surgical abilities, this can be a misguided approach. “The real purpose of the ABSITE is to evaluate the programs and not so much the individual taking the exam,” said Dr. Harthun. “Some people lose track of that.” In fact, the American Board of Surgery (ABS) does not provide residents with a score report or “transcript.” Instead, results are given directly to program directors to gauge the progression of the surgeons-in-training in their program. “There is no such thing as failing the ABSITE,” said Jeffrey Matthews, MD, Dallas B. Phemister Professor of Surgery, chair of the Department of Surgery at the University of Chicago Medical Center in Illinois, and associate editor of Schwartz’s Principles of Surgery. In one respect, however, the importance of the test is clear: ABSITE scores directly correspond to passing or failing the General Surgery Qualifying Exam at the end of residency training. Several studies have looked at the relationship and found that scoring below the 30th or 35th percentile during residency leads to a higher risk for failing the exam.3,4 The test itself is familiar to senior-level residents; however, for junior residents, the severity of the exam can come as a bit of a shock. “All residents have had a pretty stellar history of doing well on tests and in school, but the
exam is so rigorous that a certain percentage of people are going to have trouble every year,” said Dr. Harthun. “This can be devastating.” Doing well on the exam begins with understanding its structure and format. There are 2 versions: The juniorlevel exam contains a 60% focus on basic science and a 40% focus on the management of clinical problems during surgery; the senior-level exam comprises a 20% focus on basic science and an 80% focus on managing clinical issues during surgery. All of the questions go through a highly rigorous drafting process, starting with program directors and consultants and ending with psychometric testing that throws out invalid or unclear questions. As a result, the ABS implores residents to not “make any assumptions about the circumstances of the question. Choose your response on the premise that there is no wasted ink!”3 Residents run into trouble when “they get too fancy with it,” said Dr. Matthews. “It’s core knowledge based on a standard curriculum. Focus in on the straightforward scenario and do not make the question more complicated than it is.” Residents who have had success with the ABSITE use study techniques that reflect this advice. Please visit www.intrainingsurgery.com to share your experience taking the 2011 ABSITE online.
References 1.
American Board of Surgery. The guide to ABS multiple-choice examinations. http://home.absurgery.org/xfer/ABSTestGuide.pdf. Accessed June 2, 2011.
2.
Taggarshe D, Mittal V. Improving surgical resident’s performance in the American Board of Surgery in Training Examination (ABSITE)—do review courses help? The program directors’ perspective. J Surg Educ. 2011;68(1):24-28.
3. de Virgilio C, Chan T, Kaji A, Miller K. Weekly assigned reading and examinations during residency, ABSITE performance, and improved pass rates on the American Board of Surgery Examinations. J Surg Educ. 2008;65(6):499-503. 4. de Virgilio C, Yaghoubian A, Kaji A, et al. Predicting performance on the American Board of Surgery qualifying and certifying examinations: a multiinstitutional study. Arch Surg. 2010;145(9):852-856.
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